title: Staged protocol in treatment of open distal tibia fracture: using lateral MIPO.
abstract: BACKGROUND
  To evaluate the radiological, clinical results in patients with open distal tibia factures, who were treated with a staged treatment protocol using the lateral minimally invasive plate osteosynthesis (MIPO) technique.
  
  
  METHODS
  From January 2007 to June 2009, 10 patients with open distal tibia fractures (Gustilo-Anderson classification II, 3; IIIA, 1; IIIB, 6) were treated using a staged treatment protocol. The initial debridement and application of an external fixator were performed within 24 hours and the mean interval from injury to definitive surgical treatment was 15 days (range, 6 to 52 days). Eight weeks later, an additional bone graft was performed in 3 patients. The follow-up duration was more than 1 year.
  
  
  RESULTS
  The mean fracture healing time was 21 weeks (range, 17 to 28 weeks), and the average Iowa ankle rating score was 84.5 points. At the last follow-up, there was no non-union, angular deformity > 5°, shortening > 10 mm or infection. In 10 patients, 2 patients had a superficial wound infection, and another 2 patients showed limitation of ankle joint motion.
  
  
  CONCLUSIONS
  This staged treatment protocol using a lateral MIPO technique is a useful alternative method for achieving high functional recovery with good healing and low complication rates in patients with an open distal tibia fracture.
authors.affiliation: Department of Orthopedic Surgery, Yeungnam University Hospital, Daegu, Korea. ossoj@med.yu.ac.kr
authors.forename: Oog Jin
authors.initials: OJ
authors.lastname: Sohn
authors.forename: Dong Hwa
authors.initials: DH
authors.lastname: Kang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016512:Ankle Injuries / Q000601:surgery*; D016025:Bone Transplantation; D002985:Clinical Protocols; D003646:Debridement; D016267:External Fixators; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy; D007507:Therapeutic Irrigation; D013978:Tibial Fractures / Q000601:surgery*; D016896:Treatment Outcome